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KMID : 0985420160380040169
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Laboratory Medicine and Quality Assurance
2016 Volume.38 No. 4 p.169 ~ p.193
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Annual Report on the External Quality Assessment Scheme for Clinical Microbiology in Korea (2015)
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Chang Jeong-Hyun
Kim Mi-Na
Kim Eui-Chong
Shin Jong-Hee
Lee Nam-Yong
Kim Sun-Joo
Jeong Seok-Hoon
Kim Jae-Seok
Kim Chang-Ki
Bae Hye-Gyung
Yoon Nam-Seob
Joo Sae-Ick
Song Dong-Joon
Kim Keon-Han
Jeong Tae-Jeon
Heo Jin
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Abstract
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Annual proficiency surveys were conducted in March, June, and September in 2015 by the Clinical Microbiology Subcommittee of the Korean Association of External Quality Assessment Service. The program covers the sections of bacteriology, advanced bacteriology and mycology, mycobacteriology, and parasitology. Each trial was composed of three sets of different combinations of five bacteria and yeasts. These sets were distributed among laboratories for Gram staining, culture, identification, and antimicrobial susceptibility tests. Five slides with fixed sputum smears were provided as part of each trial for acid-fast bacilli detection. The survey material distribution was section-based. Two survey materials were provided in each trial, while five specimens for mycobacterial culture and identification, five specimens for anti-tuberculosis susceptibility testing and two Mycobacterium tuberculosis strains for rapid detection of rifampin and isoniazid resistance were distributed in the March and June trials. Five virtual microscopy files for stool parasite examination were availed by registered participants in the June trial. Out of the 334 enrolled laboratories, 328 (98.2%), 328 (98.2%), and 329 (98.5%) submitted responses in trials I, II, and III, respectively. Identification of bacteria, namely, Escherichia coli , Klebsiella pneumoniae , Enterococcus faecalis , Pseudomonas aeruginosa , Streptococcus pneumoniae , and Vibrio fluvialis by more than 95% of participants was acceptable. Surveillance cultures for vancomycin-resistant enterococci and carbapenem-resistant Enterobacteriaceae were determined accurately by 75.8%?85.3% and 93.1% of the respondents, respectively. Species-level identification of Candida krusei , Candida lusitanae , and Candida guilliermondii was still low at 79.8%, 55.7%, and 42.7%, respectively. Disk diffusion method revealed an unacceptably high false-positive rate of resistance to glycopeptides in E. faecalis and to trimethoprim-sulfamethoxazole in S . pneumoniae . Advanced bacteriology trials revealed unsatisfactory results for species-level identification of moulds. Mycobacterial culture, identification and susceptibility testing, and molecular detection of rifampin and isoniazid resistance were performed exceedingly well by participants. Hymenolepsis diminuta could not be identified by participants, with a correct answer rate of only 46.5% and ‘no parasite seen’ answer rate of only 31.8% for negative specimens. Species-level identification of Candida and moulds was challenging for clinical microbiology laboratories. Disk diffusion method was found to be problematic in testing the susceptibility of microorganisms to glycopeptides and trimethoprim-sulfamethoxazole. Improvement is required in result interpretation of negative specimens in parasitology.
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KEYWORD
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Quality control, Parasitology, Bacteriology, Microbiology, Mycobacterium, Antimicrobial susceptibility
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